[Demonstration of mycoplasma in suprapubic vesical puncture urine (author's transl)]

Ureaplasma urealyticum serotypes in urinary tract disease

Ureaplasma urealyticum cultures from 124 patients with urinary tract disease were serotyped by indirect immunofluorescence, using antisera to serotypes I to VIII. A similar range of serotypes was recovered from first-voided, midstream, and bladder-aspiration (SPA) urine, upper urinary tract samples, and vaginal swabs. Serotype VI was predominant (44/124) among the samples, whereas serotypes V (1/124 samples) and VII (0/124 samples) were uncommon. Twenty of 124 cultures contained more than one serotype, and three cultures were untypeable. Serotypes cultured from bladder urine were also present in vaginal and urethral samples, although these samples often carried additional serotypes. Consecutive SPA samples from the same patient invariably contained the same serotype, whereas some consecutive midstream urine samples showed a loss or gain of serotypes with time. One patient carried the same serotype in SPA urine over a period of 13 months. The pattern of serotypes recovered from the urinary tract was similar irrespective of the sampling site, the site of infection, the clinical diagnosis and renal function of the patient, and the presence or absence of other microorganisms. Colonization above the urethra and association with urinary tract disease appeared to be serotype independent.

Immunoglobulin classes of urinary and serum antibodies in mycoplasmal pyelonephritis

During 9 attacks of M. hominis pyelonephritis in 8 patients, the presence of IgA, IgG and IgM antibodies in urine and serum was studied by an indirect immunofluorescence technique. Antibodies were present in the urine for a period of 12 days. One to 4 days after the onset of the attack, IgA was in all cases demonstrable in urine, followed later by IgG. IgM was present in the urine of one patient only during the first 4 days of illness. In serum, IgG appeared as early as 1-4 days after the attack, followed later by IgA and IgM, IgA disappearing after one to two weeks.

Mycoplasmas in human pyelonephritis: demonstration of antibodies in serum and urine

This study was carried out to elucidate by serological examination the etiological significance of mycoplasmas isolated from the upper urinary tract of patients with pyelonephritis. The occurrence of antibodies in patients with acute pyelonephritis, chronic pyelonephritis with or without exacerbation, or noninfectious urinary tract disease was compared by the indirect hemagglutination method. Antibody response was demonstrated significantly more often in patients yielding growth of Mycoplasma hominis from the upper urinary tract than in patients not yielding growth. Antibodies against M. hominis were demonstrated in ureteric and bladder urine from three patients with acute pyelonephritis and from one patient with exacerbation of chronic pyelonephritis. M. hominis was isolated from the upper urinary tract of all four patients. Urine antibodies could not be demonstrated in any other cases. Thus, it seems highly possible that M. hominis may play a role in pyelonephritis of humans. The investigations did not disclose a similar role for Ureaplasma urealyticum.

Occurrence of mycoplasmas in urinary tracts of patients with acute pyelonephritis

Mycoplasma hominis was isolated from the upper urinary tract in 7 of 80 patients with acute pyelonephritis and from 0 of 60 patients with noninfectious diseases of the urinary tract, a significant difference. In four cases M. hominis was isolated in pure culture, in one it was isolated together with Ureaplasma urealyticum, and in two it was isolated with bacteria. U. urealyticum was isolated from the upper urinary tract of five patients, all with acute pyelonephritis; this was not significantly different from the control group.